The Potential of Supportive Housing

1
The Potential of Supportive Housing

• NM LEGISLATIVE
• HEALTH AND HUMAN SERVICES COMMITTEE
• Marti Knisley
• The Technical Assistance Collaborative
• October 15, 2008
• www.tacinc.org

2
What is Supportive Housing

• A cost-effective combination of permanent,
  affordable housing with services that helps
  people with disabilities and persons with limited
  incomes who have needs for supportive services
  live more stable, healthy productive lives

3
What is Supportive Housing ?

• It is permanent, meaning each tenant may stay as
  long as he or she pays rent and complies with
  terms of lease or rental agreement
• It is affordable, meaning each tenant pays no
  more than 30 to 50 of household income
• Tenants have access to an array of support
  services that are intended to support housing
  stability, recovery and resiliency, but
  participation in support services is not a
  requirement for tenancy
• Options are available for adults who are single,
  those who choose to share housing, youth
  transitioning out of juvenile or protective
  services and families with children
• Housing First low demand models provide
  access for tenants with long histories of
  homelessness, incarceration, foster care
  institutionalization, residential treatment and
  significant obstacles to housing stability often
  at much lower cost than they are being served in
  traditional care

4
Supportive Housing is Cost Effective

• Medicaid, health and other human services systems
  incur substantial costs providing care often with
  mixed success
• Costs of serving homeless people with serious
  mental illness up to
• 40,000 / year or more mostly in health care
  systems
• 28,000 annual costs in Maine mostly health care
  in hospitals
• 28,000 average annual health costs for Boston
  street dwellers
• Health care costs for public inebriates typically
  exceed 8,000/year
• 46,700 average Medicaid charges prior to
  supportive housing move-in for chronic alcoholics
  in Seattle

5
Supportive Housing is Cost Effective

• Supportive housing significantly reduces the need
  for costly emergency care and hospitalizations
• 45 fewer days of nursing home care and 42
  fewer days inpatient hospitalization in Chicago
  
• 56 fewer emergency room visits and 44 fewer
  inpatient admissions in San Francisco
• 77 fewer inpatient hospitalizations and 60
  fewer ambulance transports in Maine
• 34 fewer emergency room visits and 40 fewer
  inpatient hospital days in Denver
• Health outcomes improve with better engagement in
  more appropriate outpatient care
• However, cost offsets only work when persons
  getting the supportive housing intervention have
  used or will use public services

6
The NM Purchasing Collaboratives
Approach to Supportive Housing

• The Behavioral Health Purchasing Collaborative is
  taking a very proactive, sensible approach to
  supportive housing
• The Collaborative began this approach by
  developing a Long Range Housing Plan in 2007
  that began with an assessment of need, an
  inventory of what housing and services resources
  exist and a blueprint for capacity building,
  new and use of available development and rental
  resources and implementing best practice service
  approaches
• The Plan provided insight to opportunities for
  leveraging resources, drawing down federal funds
  and efficient use of existing resources
• ---with one caveat these opportunities are
  tied to successful partnerships between the
  services system and housing development and
  management systemsthe MFA, local Public Housing
  Authorities, Community Development organizations
  and developers

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The NM Purchasing Collaboratives
Approach to Supportive Housing

• The assessment was also revealed
• Over 30,000 New Mexicans with disabilities living
  on fixed incomes at 30 or below the Area Median
  Income are in need of supportive housing
• Vets, tribal members, families in the protective
  services system have high service needs and low
  incomes
• Most New Mexico communities have little capacity
  and infrastructure to create and sustain deeply
  affordable housing with services attached to
  their housing
• Rental resources, the backbone of any supportive
  housing plan are scare and need to generated for
  the Plan to be successful
• Based on these assessments, the Purchasing
  Collaborative immediately began implementing the
  Plan with a FY 2008 funding request of 750,000
  to high priority areas and a focus on creating
  partnerships and a focus on capacity building and
  creating rental resources tied to services

8
The NM Purchasing Collaboratives
Approach to Supportive Housing

• The 750,000 Allocation was targeted to
• 150,000 in MFA Pre-development grant funds that
  was awarded to two developers who agreed to
  target units for persons needing supportive
  housing
• 250,000 for Capacity Building grants also
  administered by MFA to two organizations who are
  developing housing and targeting units for
  supportive housing
• 350,000 to pilot Linkages, a new bridge rental
  subsidy program jointly administered by local
  housing administrators and service providers to
  test out the feasibility of model that utilizes
  rental subsides and services funds---ultimately
  leading to a largely federally funded program
  once capacity is established
• This program began with serving 30 persons in the
  Silver City and Demming area, Santa Fe and
  Albuquerque
• The program is focused on seriously mentally ill
  persons (including those with substance abuse
  disorders) who are homeless, those at risk of
  homelessness and off reservation Native
  Americans

9
The NM Purchasing Collaboratives
Approach to Supportive Housing

• In FY 2008, CYFD utilizing 150,000 of their own
  operating funds developed a small 20 youth
  rental assistance/services pilot in partnership
  with the Supportive Housing Coalition of New
  Mexico to test out the feasibility of this model
  for youth transitioning out of the juvenile
  services and protective service programs in
  Albuquerque
• Early indications from both pilots this is a
  feasible model and should be expanded across the
  state
• Armed with this Plan and experience with pilots,
  the Collaborative is moving forwarded with---a
  new partnership for with MFA in their 2009 Low
  Income Tax Credit Program application giving
  incentives to developers who target units for
  persons with disabilities
• ---work with local communities to build capacity
  
• ---preparing to take advantage of federal
  funding opportunities

10
Federal Housing Actions
Potential for New Mexico

• We are entering into an unusually positive and
  active
• period of supportive housing activity at the
  federal level
• Greater Congressional interest due to major
  alliances among national policy, advocacy and
  trade groups, very positive outcomes of
  supportive housing and the housing and credit
  crisis creating a need for more affordable
  housing and jobs
• This interest has translated into
• Passage of the Housing and Economic Recovery Act
  which includes the National Housing Trust Fund,
  the Neighborhood Stabilization Program and many
  other provisions
• Movement on the Frank Melville Act

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Federal Housing Actions
Potential for New Mexico

• The National Housing Trust Fund (part of Natl.
  Housing and
• Economic Recovery Act)
• 90 of the funds must be used for production,
  preservation, rehabilitation or operation of
  rental housing
• 75 of the funds must benefit extremely low
  income households (people at or below 30 of the
  AMI) and all funds must benefit very low income
  households. 
• It will be distributed by HUD in grants to the
  states
• The HUD Secretary will establish a distribution
  formula within 12 months and the state has two
  years to spend its allocation 
• Funds will be available in 2010/funding is
  generated on Fannie Mae and Freddie Mac
  transactions
• States need capacity to use funds within allotted
  timeframes

12
Federal Housing Actions
Potential for New Mexico

• Neighborhood Stabilization Program (part of the
  Natl. Housing and
• Economic Recovery Act)
• A 3.92 billion CDBG program for the
  redevelopment of abandoned and foreclosed
  properties
• Grantees are CDBG jurisdictions (both state and
  local)
• Funds can go toward both single family and rental
  properties and 25 of the resources must benefit
  people at 50 or below of Area Median Income
• Based on huge rush to get these funds into
  communities and create construction jobs, many
  CDBG requirements can be waived and there is no
  one-for-one replacement requirement
• Natl. disability groups are working this week to
  proposes mechanisms to assure people with
  disabilities will benefit from this program

13
Federal Housing Actions
Potential for New Mexico

• Section 811 Reform Frank Melville Act (HR
  5772)
• Section 811 is a federally funded, deeply
  affordable permanent rental housing program for
  people with disabilities. Funding covers housing
  production, rental assistance and services
• This bill reforming the Section 811 program has
  passed out of the House and just introduced in
  the Senate
• It authorizes a new and innovative Section 811
  Project Rental Assistance Contract (PRAC)
  Demonstration program to create thousands of new
  Section 811 units each year without substantially
  increasing Section 811 appropriations levels by
  leveraging new set-asides of supportive housing
  units in federal Low Income Housing Tax Credit
  (LIHTC) properties and HOME-funded projects
• This program uses a competitive funding process
  and states with supportive housing capacity will
  likely be more successful